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Hamza H, Baez VM, Al-Ansari A, Becker AT, Navkar NV. User interfaces for actuated scope maneuvering in surgical systems: a scoping review. Surg Endosc 2023:10.1007/s00464-023-09981-0. [DOI: 10.1007/s00464-023-09981-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/25/2023] [Indexed: 03/29/2023]
Abstract
Abstract
Background
A variety of human computer interfaces are used by robotic surgical systems to control and actuate camera scopes during minimally invasive surgery. The purpose of this review is to examine the different user interfaces used in both commercial systems and research prototypes.
Methods
A comprehensive scoping review of scientific literature was conducted using PubMed and IEEE Xplore databases to identify user interfaces used in commercial products and research prototypes of robotic surgical systems and robotic scope holders. Papers related to actuated scopes with human–computer interfaces were included. Several aspects of user interfaces for scope manipulation in commercial and research systems were reviewed.
Results
Scope assistance was classified into robotic surgical systems (for multiple port, single port, and natural orifice) and robotic scope holders (for rigid, articulated, and flexible endoscopes). Benefits and drawbacks of control by different user interfaces such as foot, hand, voice, head, eye, and tool tracking were outlined. In the review, it was observed that hand control, with its familiarity and intuitiveness, is the most used interface in commercially available systems. Control by foot, head tracking, and tool tracking are increasingly used to address limitations, such as interruptions to surgical workflow, caused by using a hand interface.
Conclusion
Integrating a combination of different user interfaces for scope manipulation may provide maximum benefit for the surgeons. However, smooth transition between interfaces might pose a challenge while combining controls.
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Zheng Q, Yang R, Ni X, Yang S, Jiang Z, Wang L, Chen Z, Liu X. Development and validation of a deep learning-based laparoscopic system for improving video quality. Int J Comput Assist Radiol Surg 2023; 18:257-268. [PMID: 36243805 DOI: 10.1007/s11548-022-02777-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/05/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE A clear surgical field of view is a prerequisite for successful laparoscopic surgery. Surgical smoke, image blur, and lens fogging can affect the clarity of laparoscopic imaging. We aimed to develop a real-time assistance system (namely LVQIS) for removing these interfering factors during laparoscopic surgery, thereby improving laparoscopic video quality. METHODS LVQIS was developed with generative adversarial networks (GAN) and transfer learning, which included two classification models (ResNet-50), a motion blur removal model (MPRNet), and a smoke/fog removal model (GAN). 136 laparoscopic surgery videos were retrospectively collected in a tripartite dataset for training and validation. A synthetic dataset was simulated using the image enhancement library Albumentations and the 3D rendering software Blender. The objective evaluation results were through PSNR, SSIM and FID, and the subjective evaluation includes the operation pause time and the degree of anxiety of surgeons. RESULTS The synthesized dataset contained 19,245 clear images, 19,245 motion blur images, and 19,245 smoke/fog images. The ResNet-50 CNN model identified whether a single laparoscopic image had motion blur and smoke/fog with an accuracy of over 0.99. The PSNR, SSIM and FID of the de-smoke model were 29.67, 0.9551 and 74.72, respectively, and the PSNR, SSIM and FID of the de-blurring model were 26.78, 0.9020 and 80.10, respectively, which were better than other advanced de-blurring and de-smoke/fog models. In a comparative study of 100 laparoscopic surgeries, the use of LVQIS significantly reduced the operation pause time (P < 0.001) and the anxiety of surgeons (P = 0.004). CONCLUSIONS In this study, LVQIS is an efficient and robust system that can improve the quality of laparoscopic video, reduce surgical pause time and the anxiety of surgeons, and has the potential for real-time application in real clinical settings.
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Affiliation(s)
- Qingyuan Zheng
- Department of Urology, Renmin Hospital of Wuhan University, 99 Zhang Zhi-dong Road, Wuhan, Hubei, 430060, People's Republic of China
- Institute of Urologic Disease, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China
| | - Rui Yang
- Department of Urology, Renmin Hospital of Wuhan University, 99 Zhang Zhi-dong Road, Wuhan, Hubei, 430060, People's Republic of China
- Institute of Urologic Disease, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China
| | - Xinmiao Ni
- Department of Urology, Renmin Hospital of Wuhan University, 99 Zhang Zhi-dong Road, Wuhan, Hubei, 430060, People's Republic of China
- Institute of Urologic Disease, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China
| | - Song Yang
- Department of Urology, Renmin Hospital of Wuhan University, 99 Zhang Zhi-dong Road, Wuhan, Hubei, 430060, People's Republic of China
- Institute of Urologic Disease, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China
| | - Zhengyu Jiang
- Department of Urology, Renmin Hospital of Wuhan University, 99 Zhang Zhi-dong Road, Wuhan, Hubei, 430060, People's Republic of China
- Institute of Urologic Disease, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China
| | - Lei Wang
- Department of Urology, Renmin Hospital of Wuhan University, 99 Zhang Zhi-dong Road, Wuhan, Hubei, 430060, People's Republic of China
- Institute of Urologic Disease, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China
| | - Zhiyuan Chen
- Department of Urology, Renmin Hospital of Wuhan University, 99 Zhang Zhi-dong Road, Wuhan, Hubei, 430060, People's Republic of China.
- Institute of Urologic Disease, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China.
| | - Xiuheng Liu
- Department of Urology, Renmin Hospital of Wuhan University, 99 Zhang Zhi-dong Road, Wuhan, Hubei, 430060, People's Republic of China.
- Institute of Urologic Disease, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China.
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Wijsman PJM, Voskens FJ, Molenaar L, van 't Hullenaar CDP, Consten ECJ, Draaisma WA, Broeders IAMJ. Efficiency in image-guided robotic and conventional camera steering: a prospective randomized controlled trial. Surg Endosc 2021; 36:2334-2340. [PMID: 33977377 DOI: 10.1007/s00464-021-08508-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 04/07/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Robotic camera steering systems have been developed to facilitate endoscopic surgery. In this study, a randomized controlled trial was conducted to compare conventional human camera control with the AutoLap™ robotic camera holder in terms of efficiency and user experience when performing routine laparoscopic procedures. Novelty of this system relates to the steering method, which is image based. METHODS Patients undergoing an elective laparoscopic hemicolectomy, sigmoid resection, fundoplication and cholecystectomy between September 2016 and January 2018 were included. Stratified block randomization was used for group allocation. The primary aim of this study was to compare the efficiency of robotic and human camera control, measured with surgical team size and total operating time. Secondary outcome parameters were number of cleaning moments of the laparoscope and the post-study system usability questionnaire. RESULTS A total of 100 patients were randomized to have robotic (50) versus human (50) camera control. Baseline characteristics did not differ significantly between groups. In the robotic group, 49/50 (98%) of procedures were carried out without human camera control, reducing the surgical team size from four to three individuals. The median total operative time (60.0 versus 53.0 min, robotic vs. control) was not significantly different, p = 0.122. The questionnaire showed a positive user satisfaction and easy control of the robotic camera holder. CONCLUSION Image-based robotic camera control can reduce surgical team size and does not result in significant difference in operative time compared to human camera control. Moreover, robotic image-guided camera control was associated with positive user experience.
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Affiliation(s)
- P J M Wijsman
- Department of Surgery, Meander Medical Center, Maatweg 3, Amersfoort, The Netherlands
- Department of Surgery, Jeroen Bosch Hospital, 's Hertogenbosch, The Netherlands
- Robotics and Mechatronics, University of Twente, Enschede, The Netherlands
| | - F J Voskens
- Department of Surgery, Meander Medical Center, Maatweg 3, Amersfoort, The Netherlands
| | - L Molenaar
- Department of Surgery, Meander Medical Center, Maatweg 3, Amersfoort, The Netherlands
- Magnetic Detection & Imaging, University of Twente, Enschede, The Netherlands
| | | | - E C J Consten
- Department of Surgery, Meander Medical Center, Maatweg 3, Amersfoort, The Netherlands
| | - W A Draaisma
- Department of Surgery, Jeroen Bosch Hospital, 's Hertogenbosch, The Netherlands
| | - I A M J Broeders
- Department of Surgery, Meander Medical Center, Maatweg 3, Amersfoort, The Netherlands.
- Robotics and Mechatronics, University of Twente, Enschede, The Netherlands.
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Wijsman PJM, Broeders IAMJ, Brenkman HJ, Szold A, Forgione A, Schreuder HWR, Consten ECJ, Draaisma WA, Verheijen PM, Ruurda JP, Kaufman Y. First experience with THE AUTOLAP™ SYSTEM: an image-based robotic camera steering device. Surg Endosc 2017; 32:2560-2566. [PMID: 29101564 DOI: 10.1007/s00464-017-5957-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 10/22/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Robotic camera holders for endoscopic surgery have been available for 20 years but market penetration is low. The current camera holders are controlled by voice, joystick, eyeball tracking, or head movements, and this type of steering has proven to be successful but excessive disturbance of surgical workflow has blocked widespread introduction. The Autolap™ system (MST, Israel) uses a radically different steering concept based on image analysis. This may improve acceptance by smooth, interactive, and fast steering. These two studies were conducted to prove safe and efficient performance of the core technology. METHODS A total of 66 various laparoscopic procedures were performed with the AutoLap™ by nine experienced surgeons, in two multi-center studies; 41 cholecystectomies, 13 fundoplications including hiatal hernia repair, 4 endometriosis surgeries, 2 inguinal hernia repairs, and 6 (bilateral) salpingo-oophorectomies. The use of the AutoLap™ system was evaluated in terms of safety, image stability, setup and procedural time, accuracy of imaged-based movements, and user satisfaction. RESULTS Surgical procedures were completed with the AutoLap™ system in 64 cases (97%). The mean overall setup time of the AutoLap™ system was 4 min (04:08 ± 0.10). Procedure times were not prolonged due to the use of the system when compared to literature average. The reported user satisfaction was 3.85 and 3.96 on a scale of 1 to 5 in two studies. More than 90% of the image-based movements were accurate. No system-related adverse events were recorded while using the system. CONCLUSION Safe and efficient use of the core technology of the AutoLap™ system was demonstrated with high image stability and good surgeon satisfaction. The results support further clinical studies that will focus on usability, improved ergonomics and additional image-based features.
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Affiliation(s)
- Paul J M Wijsman
- Deparment of Surgery, Meander Medical Center, Maatweg 3, Amersfoort, The Netherlands.
| | - Ivo A M J Broeders
- Deparment of Surgery, Meander Medical Center, Maatweg 3, Amersfoort, The Netherlands
| | - Hylke J Brenkman
- Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Amir Szold
- Assia Medical Group, Assuta Medical Center, Tel Aviv, Israel
| | | | - Henk W R Schreuder
- Department of Gynecologic Oncology, UMC Utrecht Cancer Center, Utrecht, The Netherlands
| | - Esther C J Consten
- Deparment of Surgery, Meander Medical Center, Maatweg 3, Amersfoort, The Netherlands
| | - Werner A Draaisma
- Deparment of Surgery, Meander Medical Center, Maatweg 3, Amersfoort, The Netherlands
| | - Paul M Verheijen
- Deparment of Surgery, Meander Medical Center, Maatweg 3, Amersfoort, The Netherlands
| | - Jelle P Ruurda
- Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Yuval Kaufman
- Department of Surgery, Assuta Medical Center, Haifa, Israel
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Abdi E, Burdet E, Bouri M, Bleuler H. Control of a Supernumerary Robotic Hand by Foot: An Experimental Study in Virtual Reality. PLoS One 2015; 10:e0134501. [PMID: 26225938 PMCID: PMC4520700 DOI: 10.1371/journal.pone.0134501] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 07/10/2015] [Indexed: 11/18/2022] Open
Abstract
In the operational theater, the surgical team could highly benefit from a robotic supplementary hand under the surgeon's full control. The surgeon may so become more autonomous; this may reduce communication errors with the assistants and take over difficult tasks such as holding tools without tremor. In this paper, we therefore examine the possibility to control a third robotic hand with one foot's movements. Three experiments in virtual reality were designed to assess the feasibility of this control strategy, the learning curve of the subjects in different tasks and the coordination of foot movements with the two natural hands. Results show that the limbs are moved simultaneously, in parallel rather than serially. Participants' performance improved within a few minutes of practice without any specific difficulty to complete the tasks. Subjective assessment by the subjects indicated that controlling a third hand by foot has been easy and required only negligible physical and mental efforts. The sense of ownership was reported to improve through the experiments. The mental burden was not directly related to the level of motion required by a task, but depended on the type of activity and practice. The most difficult task was moving two hands and foot in opposite directions. These results suggest that a combination of practice and appropriate tasks can enhance the learning process for controlling a robotic hand by foot.
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Affiliation(s)
- Elahe Abdi
- Robotic Systems Laboratory, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Etienne Burdet
- Department of Bioengineering, Imperial College of Science, Technology and Medicine, London, United Kingdom
| | - Mohamed Bouri
- Robotic Systems Laboratory, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Hannes Bleuler
- Robotic Systems Laboratory, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
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